MEDICARE: DR. JOHANNA E RAHMAN MD, MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1871912089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHANNA E RAHMAN MD, MPH

Provider Business Mailing Address
First Line	:	217 E 70TH ST UNIT 2368
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-9007
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	337 KENT AVE APT 4C
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11249-5193
Country	:	US
Telephone Number	:	415-948-4502
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	03/17/2018

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